Birth Control &

Family Planning

Nathan Matza, MA, DrPH(c), CHES

Adapted from Clinical Staff
Huntington Beach Community Clinic, © 2002
Revised 4/02
 Remember:
The total risks of
birth control are
much less than the
total risks of a
pregnancy!!
Teen Hotline

714-847-7242
Birth Control Choices
 Married life with children
 Married life without children
 Single life without children
 Adoption of child
 Communal life
 Living together
 Teens & Birth Control:
Excuses...Excuses...Excuses
 “It was unromantic and planned”
 “I Would feel guilty”
 “It is against my religion”
 “We used the withdrawal method”
 “Doctor will blab to my mom”
 “It won’t happen to me”
 “Condoms break and don’t work”
 Birth Control Methods
 1 million teens became pregnant in 2000
 512,000 of these teens gave birth
 6 of 10 U.S. pregnancies are unplanned
 Most teens do not plan to have sex the first
time forget to use a birth control method
 Majority of teen pregnancies in California
result from men over age 21 !
 Types of Birth Control
 Hormonal
 Barrier
 IUD
 Methods based on information
 Permanent sterilization
 Hormonal Methods
 Oral Contraceptives
(Birth Control Pill)
 Injections (Depo-Provera)
 Implants (Norplant I & II)
 Birth Control Pills
 Pills can be taken to prevent pregnancy
 Pills are safe and effective when taken
properly
 Pills are over 99% effective
 Women must have a pap smear to get a
prescription for birth control pills
 How does the pill work?
 Stops ovulation
 Thins uterine lining
 Thickens cervical mucus
Positive Benefits of Birth Control Pills

 Prevents Decreases
pregnancy incidence of
 Eases menstrual ovarian cysts
cramps Prevents
 Shortens period ovarian and
 Regulates period uterine cancer
Decreases acne
 Side-effects
 Breast  Moodiness
tenderness  Weight change
 Nausea  Spotting
 Increase in
headaches
 Taking the Pill
 Once a day at the same time everyday
 Use condoms for first month
 Use condoms when on antibiotics
 Use condoms for 1 week if you miss a
pill or take one late
 The pill offers no protection from
STD’s
 Depo-Provera

 Birth control shot given once every

three months to prevent pregnancy
 99.7% effective preventing pregnancy
 No daily pills to remember
How does the shot work?

 Stops ovulation
 Stops menstrual cycles!!
 Thickens cervical mucus
 SIDE EFFECTS
 Extremely irregular menstrual bleeding
and spotting for 3-6 months!
 NO PERIOD  after 3-6 months
 Weight change
 Breast tenderness
 Mood change

*NOT EVERY WOMAN HAS SIDE-EFFECTS!

 IMPLANTS
 Implants are placed in the body filled
with hormone that prevents pregnancy
 Physically inserted in simple 15 minute
outpatient procedure
 Plastic capsules the size of paper
matchsticks inserted under the skin in
the arm
 99.95% effectiveness rate
 Norplant I vs. Norplant II

 Six capsules  Two capsules

 Five years  Three years
Norplant Implant
 Norplant Considerations
 Should be considered long term
birth control
 Requires no upkeep 
 Extremely effective in pregnancy
prevention > 99%
Emergency Contraception
Emergency contraception
pills can reduce the
chance of a pregnancy by
75% if taken within 72
hours of unprotected sex!
 Emergency Contraception
(ECP)

 Must be taken within 72 hours of the

act of unprotected intercourse or
failure of contraception method
 Must receive ECP from a physician
 75 – 84% effective in reducing
pregnancy
 California pharmacies can prescribe
without a doctor! (1/1/02)
 ECP
 Floods the ovaries with high amount of
hormone and prevents ovulation
 Alters the environment of the uterus,
making it disruptive to the egg and sperm
 Two sets of pills taken exactly 12
hours apart
 BARRIER METHODS
 Spermicides
 Male Condom
 Female Condom
 Diaphragm
 Cervical Cap
 BARRIER METHOD
 Prevents pregnancy blocks the
egg and sperm from meeting
 Barrier methods have higher
failure rates than hormonal
methods due to design and
human error
 SPERMICIDES
 Chemicals kill sperm in the vagina
 Different forms:
-Jelly -Film
-Foam -Suppository
 Some work instantly, others require
pre-insertion
 Only 76% effective (used alone), should
be used in combination with another
method i.e., condoms
 MALE CONDOM

• Most common and effective barrier

method when used properly
• Latex and Polyurethane should only
be used in the prevention of
pregnancy and spread of STI’s
(including HIV)
 MALE CONDOM
 Perfect effectiveness rate = 97%
 Typical effectiveness rate = 88%
 Latex and polyurethane condoms
are available
 Combining condoms with
spermicides raises effectiveness
levels to 99%
 FEMALE CONDOM
 Made as an alternative to male
condoms
 Polyurethane
 Physically inserted in the vagina
 Perfect rate = 95%
 Typical rate = 79%
 Woman can use female condom if
partner refuses
Reality  : The Female
Condom
 DIAPRAGHM
 Perfect Effectiveness Rate = 94%
 Typical Effectiveness Rate = 80%
 Latex barrier placed inside vagina
during intercourse
 Fitted by physician
 Spermicidal jelly before insertion
 Inserted up to 18 hours before
intercourse and can be left in for a
total of 24 hours
DIAPHRAGM
 CERVICAL CAP
 Latex barrier inserted in vagina before
intercourse
 “Caps” around cervix with suction
 Fill with spermicidal jelly prior to use
 Can be left in body for up to a total of
48 hours
 Must be left in place six hours after
sexual intercourse
 Perfect effectiveness rate = 91%
 Typical effectiveness rate = 80%
 INTRAUTERINE DEVICES
(IUD)
 T-shaped object placed in the uterus to
prevent pregnancy
 Must be on period during insertion
 A Natural childbirth required to use
IUD
 Extremely effective without using
hormones > 97 %
 Must be in monogamous relationship
 Copper T vs.. Progestasert
 10 years  1 year
 99.2 % effective  98% effective
 Copper on IUD acts  T shaped plastic
as spermicide, IUD that releases
hormones over a
blocks egg from one year time frame
implanting
 Thickens mucus,
 Must check string blocking egg
before sex and after  Check string before
shedding of uterine sex & after shedding
lining. of uterine lining.
 STERILIZATION
 Procedure performed on a man or
a woman permanently sterilizes
 Female = Tubal Ligation
 Male = Vasectomy
 TUBAL LIGATION
 Surgical procedure performed on a
woman
 Fallopian tubes are cut, tied,
cauterized, prevents eggs from
reaching sperm
 Failure rates vary by procedure, from
0.8%-3.7%
 May experience heavier periods
LAPAROSCOPY-’BAND-AID’
STERILIZATION
 VASECTOMY
 Male sterilization procedure
 Ligation of Vas Deferens tube
 No-scalpel technique available
 Faster and easier recovery than a
tubal ligation
 Failure rate = 0.1%, more effective
than female sterilization
VASECTOMY
 METHODS BASED ON
INFORMATION
 Withdrawal
 Natural Family Planning
 Fertility Awareness Method
 Abstinence
 WITHDRAWAL
 Removal of penis from the vagina before
ejaculation occurs
 NOT a sufficient method of birth control
by itself
 Effectiveness rate is 80% (very
unpredictable in teens, wide variation)
 1 of 5 women practicing withdrawal
become pregnant
 Very difficult for a male to ‘control’
 Natural Family Planning &
Fertility Awareness Method
 Women take a class on the menstrual cycle
to calculate more fertile times
 Requires special equipment and cannot be
self-taught
 NFP abstains from sex during the
calculated fertile time
 FAM uses barrier methods during fertile
time
 Perfect effectiveness rate = 91%
 Typical effectiveness rate = 75%
 No 100% safe day-irregular periods
 Abstinence
 Only 100% method of birth control
 Abstinence is when partners do
not engage in sexual intercourse
 Communication between partners
is important for those practicing
abstinence to be successful
 Reasons for abstaining
 Moral or religious values
 Personal beliefs
 Medical reasons
 Not feeling ready for a emotional,
intimate relationship
 Future plans
 SOMETHING TO THINK ABOUT…

Couples who use no birth control

have a 85% chance of a pregnancy
within the first year.

Will you be one of the 512,000 of

the teens that gave birth in 2000?
 TEEN HOTLINE
ORANGE COUNTY

714-847-7242
 EXCELLENT REFERENCE SEE:

www.plannedparenthood.org/bc
Hatcher, Robert, MD
Contraceptive Technology ,17ed. (2001)